Acute Ischemic Cerebrovascular Syndrome

Kidwell, Chelsea S.; Warach, Steven

doi:10.1161/01.str.0000098902.69855.a9

Cited by 170 publications

(114 citation statements)

References 22 publications

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“…Perhaps the proposed term acute ischemic cerebrovascular syndrome better reflects the evolution of thinking about the spectrum of TIA and stroke. 35 This paradigm shift is highlighted in both recent reviews and guidelines published by the AHA in 1999 and NSA in 2000. 4,19,20,22 Nevertheless, the published medical literature continues to show a great deal of variability in physicians' compliance with these guidelines.…”

Section: Discussionmentioning

confidence: 99%

National Study on Emergency Department Visits for Transient Ischemic Attack, 1992–2001

Edlow

Kim

Pelletier

et al. 2006

Academic Emergency Medicine

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Objectives: To describe the epidemiology of U.S. emergency department (ED) visits for transient ischemic attack (TIA) and to measure rates of antiplatelet medication use, neuroimaging, and hospitalization during a ten-year time period.Methods: The authors obtained data from the 1992-2001 National Hospital Ambulatory Medical Care Survey. TIA cases were identified by having ICD-9 code 435.Results: From 1992 to 2001, there were 769 cases, representing 2,969,000 ED visits for TIA. The population rate of 1.1 ED visits per 1,000 U.S. population (95% CI = 0.92 to 1.30) was stable over time. TIA was diagnosed in 0.3% of all ED visits. Physicians administered aspirin and other antiplatelet agents to a small percentage of patients, and 42% of TIA patients (95% CI = 29% to 55%) received no medications at all in the ED. Too few data points existed to measure a statistically valid trend over time. Physicians performed computed tomography scanning in 56% (95% CI = 45% to 66%) of cases and performed magnetic resonance imaging (MRI) in <5% of cases, and there was a trend toward increased imaging over time. Admission rates did not increase during the ten-year period, with 54% (95% CI = 42% to 67%) admitted. Regional differences were noted, however, with the highest admission rate found in the Northeast (68%).Conclusions: Between 1992 and 2001, the population rate of ED visits for TIA was stable, as were admission rates (54%). Antiplatelet medications appear to be underutilized and to be discordant with published guidelines. Neuroimaging increased significantly. These findings may reflect the limited evidence base for the guidelines, educational deficits, or other barriers to guideline implementation.ACADEMIC EMERGENCY MEDICINE 2006; 13:666-672 ª

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Section: Discussionmentioning

confidence: 99%

National Study on Emergency Department Visits for Transient Ischemic Attack, 1992–2001

Edlow

Kim

Pelletier

et al. 2006

Academic Emergency Medicine

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“…The latter type also includes cases occurring after CABG with CPB (8) . Binocular amaurosis fugax associated with bilateral total blindness has also been described, with an incidence of less than 0.5% (9) . However, some other studies have reported a prevalence rate of 1.3-2% among patients undergoing openheart surgery (10) .…”

Section: Discussionmentioning

confidence: 99%

A Rare Neurologic Complication of Coronary Artery Bypass Graft Surgery: Occipital Infarction with Binocular Amaurosis Fugax

Abud¹

2015

Kosuyolu Heart Journal

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Herein, we report a major but transient neurologic complication occurring early after coronary artery bypass grafting with cardiopulmonary bypass. In June 2010, a 63-year-old male patient with a history of unstable angina pectoris and severe coronary stenosis was admitted for surgery. He also had a past medical history of hypertension, hyperlipidemia and smoking for 38 years. Preoperative neurological examination was normal with no visual disturbance or orbital motor dysfunction. Physical examination of other organ systems were also normal. During the early postoperative hours, the patient was clinically stable. Direct and consensual light refl exes were normal bilaterally. Following extubation, bilateral total loss of vision developed. Computed tomography of the brain at postoperative day 1 revealed a cerebral infarction with surrounding tissue edema in the occipital lobes. Following the anti-edematous treatment, a gradual improvement of vision occurred in both eyes. Despite the dramatic improvement in visual functions, a computed tomography of the brain at postoperative day 12 showed the persistence of initial radiological fi ndings, suggesting amaurosis fugax, which is generally defi ned as a transient monocular visual loss and blindness. Binocular amaurosis fugax associated with bilateral total blindness due to postoperative ischemic optic neuropathy has also been described, with an incidence of less than 0.5%. Some other studies have reported a prevalence rate of 1.3-2% among patients undergoing open-heart surgery. In any case, bilateral amaurosis fugax developing as a transient postoperative neurological complication after coronary artery bypass grafting represents a rare condition. Radiological imaging studies may sometimes fail to detect the condition and complete restoration of visual functions may be achieved by appropriate anti-edema therapy.Key Words: Amaurosis fugax; postoperative complications; coronary artery bypass Koroner Arter Greft Baypas Cerrahisine Bağlı Nadir Bir Nörolojik Komplikasyon: Oksipital İnfarkt Sonrası Binoküler Amarozis Fugaks ÖZETYazımızda koroner arter baypas cerrahisinin erken döneminde görülebilen, geçici olan, majör bir nörolojik komplikasyonu sunmaktayız. Ciddi koroner arter lezyonları olan 63 yaşındaki bir hasta cerrahi tedavi için kliniğimize yatırıldı. Ameliyat öncesi değerlendirmede hastanın yüksek tansiyon, hiperlipidemi ve sigara öyküsü mevcut idi. Hastada nörolojik bir patoloji ve görme kusuru yoktu. Diğer fi zik muayene bulguları olağandı. Ameliyat sonrası erken dönemde hasta entübe iken durumu stabil seyretti. Puppileride ışık refl eksine cevap veriyordu. Ekstübasyondan hemen sonra hasta göremediğinden bahsediyor, kör olduğunu söylüyordu. Bunun üzerine hastaya beyin tomografi si çekildi ve oksipital lobda enfarkt alanı ve çevresinde ödem saptandı. Hastaya antiödem tedavisi başlandıktan kısa süre sonra hastanın görme fonksiyonları düzeldi. Postop 12. günde çekilen kontrol tomografi de, hastanın görme fonksiyonunun çabucak düzelmiş olmasına rağmen, radiyoloji...

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“…The presence of acute ischemic stroke in the anterior circulation was identified by 2 experienced neurologists (Ͼ10 years' experience) on the basis of the clinical and the imaging findings. 15 MR imaging for carotid arteries was performed within 1 week after neurovascular symptom onset.…”

Section: Study Populationmentioning

confidence: 99%

Comparison of Carotid Atherosclerotic Plaque Characteristics by High-Resolution Black-Blood MR Imaging between Patients with First-Time and Recurrent Acute Ischemic Stroke

Liu

Zhao

Cao

et al. 2012

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: It has been shown that patients with a first ischemic stroke are at high risk of developing recurrent stroke due to carotid atherosclerotic plaque rupture. However, no one has defined the difference in plaques between initial and recurrent stroke. This study sought to investigate the characteristics of carotid plaque between patients with first-time and recurrent acute ischemic stroke by using MR imaging.

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Acute Ischemic Cerebrovascular Syndrome

Cited by 170 publications

References 22 publications

National Study on Emergency Department Visits for Transient Ischemic Attack, 1992–2001

National Study on Emergency Department Visits for Transient Ischemic Attack, 1992–2001

A Rare Neurologic Complication of Coronary Artery Bypass Graft Surgery: Occipital Infarction with Binocular Amaurosis Fugax

Comparison of Carotid Atherosclerotic Plaque Characteristics by High-Resolution Black-Blood MR Imaging between Patients with First-Time and Recurrent Acute Ischemic Stroke

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